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Tuberculosis technical instructions for panel physicians
  • Published Date:
    1/31/19
  • Language:
    English
Filetype[PDF-2.47 MB]


Details:
  • Description:
    The medical screening for tuberculosis among persons overseas applying for US immigration status and nonimmigrants who are required to have an overseas medical examination, hereafter referred to as applicants, is an essential component of the medical evaluation. Because tuberculosis is a challenging disease to diagnose, treat, and control, these instructions are designed to enable panel physicians overseas to detect and treat infectious forms of tuberculosis among applicants and to reduce the risk of spread of tuberculosis among the US population after immigration.

    Pulmonary tuberculosis is a disease that involves the lung parenchyma and is often infectious (i.e., contagious [determined by sputum smear examination for acid-fast bacilli (AFB) and mycobacterial culture]). Laryngeal tuberculosis is rare but highly infectious. Disease of the lung parenchyma may occur concurrently with pleural tuberculosis, and the parenchymal lung disease may not be apparent on chest radiograph because of compression of affected lung tissue by pleural fluid. Because the emphasis for the pre-immigration medical evaluation is on infectiousness, for the purpose of this document, the term tuberculosis disease refers to disease of the lung parenchyma, pleural tuberculosis, laryngeal tuberculosis, and tuberculosis of the intrathoracic lymph nodes. Other forms of extrapulmonary tuberculosis and latent tuberculosis infection (LTBI) are not included in the definition of tuberculosis disease for the purposes of these Technical Instructions and are defined separately.

    The Division of Global Migration and Quarantine (DGMQ) developed these instructions in consultation with US tuberculosis subject matter experts and US panel physicians. These instructions define the specific responsibilities of panel physicians in terms of testing and treatment of tuberculosis disease among applicants overseas for purposes of US immigration medical eligibility only. These instructions are specific to the immigration medical evaluation and should not be used as guidelines to test for or treat tuberculosis disease in other settings or as a clinical manual that defines detailed laboratory procedures or specific treatment regimen details. Drug-susceptible tuberculosis disease treatment of applicants must be consistent with the current Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.

    The instructions in this document supersede all previous Tuberculosis Technical Instructions, Updates to the Technical Instructions, memoranda and letters to panel physicians, and memoranda and letters to international refugee resettlement organizations. These instructions are to be followed for tuberculosis disease screening and treatment of all applicants.

    CS297106-A

    Publication date from document properties.

    TB-panel-tech-instructions-h.pdf

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